Medieval Health: Bubonic Plague

During the Middle Ages, little was feared as much as the incurable bubonic plague, often referred to as the Black Death. It reportedly broke out fiercely within the Gobi Desert during the early 1300s. From there, it spread rampantly
reaching as far as China to Europe, primarily through key trade routes used by traveling merchants. These tradesmen typically brought their business to city centers. This meant that the highly crowded cities would soon succumb to the
disease, especially since hygiene standards were fairly poor or even non-existent at the time. Occasionally it might have been a traveler who brought the illness with them, even though the signs may not have shown yet. More often
though, bubonic plague was carried through infected insects or vermin, that had stowed away in the merchants' caravans.

Bubonic plague was so highly feared for good reason. It struck without warning, often when fleas were passed on from infected rodents to humans. Within a few days of becoming infected, the human host would show alarming symptoms that
included uncontrollable fevers, vomiting blood, and sore limbs. The lymph nodes situated under the armpits and at the neck and groin would swell severely and turn black. At this point, they would explode, causing death. The entire
ordeal usually only lasted as much as four days, leaving people helpless and with little hope for a cure.

Today, scientists and doctors have developed cures and preventions for bubonic plague. However, in the Middle Ages, the physicians of the time lacked proper medical knowledge and were also limited in their comprehension of how the human
body functions. These factors, coupled with the utter lack of hygiene, malnutrition, and rampancy of other diseases allowed the plague to spread quickly and fiercely. Due to the lack of understanding of the disease, most common people
simply attributed it to superstitious causes. Among the European Christians, a great fear spread. They fervently believed that the plague had struck them as a sign of God's anger. To express their remorse, they would flagellate
themselves in public, and eventually were condemned by the pope. Others assumed that the plague was carried into cities as a large invisible gas cloud. Accordingly, they most often turned to superstitious preventions and cures that
were of no real help in warding off the plague. Among these were potions containing arsenic and mercury, carrying posies or pomanders of sweet-smelling flowers, creating loud noises, and attaching lucky charms. Since the plague caused
such a foul smell in its victims, the flowers were meant to disguise these odors. Doctors would sometimes suggest allowing the patient to sweat profusely to let the disease pass from their bodies.

Despite these futile superstitions, some public officials did hit upon certain truths. For example, in Italy, public officials recognized the importance of isolation in cases of the plague. The Venetians blocked off incoming ships to
keep their city free of the disease, while the Milanese literally bricked up the houses of diseased people. Scholars, clergy, and physicians, however all had varying opinions based on their fields of expertise. Out of the confusion,
one fruitful solution was proposed: the use of heat to combat the disease. Plague corpses as well as all of their clothing and belongings would be burned to kill any lingering disease, and then buried. The plague often affected poor
people more than nobles, since they could not afford to isolate themselves well. In some instances, if the plague had hit a city, the people would not be allowed to leave the boundaries unless they had special permission. People with
an infected member in their household would have their doors marked with a large cross as a symbol of warning to others. If physicians refused to enter and treat them, the infected person would have to rely on their family members for
some comfort. In a large number of areas, the entire family would be shut in with the diseased person, in case they too were infected. Occasionally untrained nurses would visit to deliver food and what little soothing they could offer.

Overall, the bubonic plague affected the population of Europe on a staggering scale. According to most estimates, approximately one third of the people died as a direct result of this plague. Some places were affected worse than others.
For example, Venice, which was a hub of trade and commerce, lost up to sixty percent of their people in less than two years. Apart from the impact on the community, the plague also had severe implications on Europe's economy. It led to
the closure of many businesses, lower volumes of trade, and abandoned townships. If one city was said to be infected with the plague, people of the surrounding areas took great measures to completely avoid it. They would even be
suspicious and wary of anyone from that city visiting them. The high death rate brought on by the plague led to the loss of several great names in the arts, culture, religion, commerce, and philosophy.

Today the Black Death is a distant memory for most people. As an eerie throwback, it is still casually echoed by none other than schoolchildren when they chant the rhyme, Ring Around the Rosy. The lyrics of the verse are said
to contain pronounced references to the symptoms of the plague, as well as the hopeful superstitious cures, and the final fatal blow that the plague would deliver upon its victims. Artists through the centuries have also been
captivated by the horrors and enormity of the plague. A number of them created varying depictions of the outbreak.

Sadly, for the people of the Middle Ages, the plague did not only break out once, but several times. It was only by the 16th century that physicians started to develop slightly better hygiene standards and preventative
measures. Even so, the later plague outbreaks were still widespread and deadly.